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如果有人面临类似问题,就需要心理健康的预防性护理

如果有人面临类似问题,就需要心理健康的预防性护理

KYU RHEE, CARA MCNULTY, AND HYONG UN 2021年10月17日
人们生活中总会遇到影响幸福感的压力、事件和诊疗,新冠疫情进一步凸显了该现实,所以掌握预防和护理方法以满足心理健康需求变得至关重要。

众所周知,关于心理健康的讨论正在增加。虽然想得出结论还需要一些时间和努力,但值得欣慰是,关于长期以来被严重污名化的话题的讨论更多了。

类似世界精神卫生日(World Mental Health Day)的纪念活动有助于推动亟需的对话。然而,纪念日除了本身很重要,也在提醒人们每一天都要当成精神健康日。人们生活中总会遇到影响幸福感的压力、事件和诊疗,新冠疫情进一步凸显了该现实,所以掌握预防和护理方法以满足心理健康需求变得至关重要。

在CVS Health旗下保险公司安泰(Aetna),我们深知轻则承受焦虑或压力,重则长期接受临床诊疗,如果有人面临类似问题,都会存在心理和情绪健康需求。为了真正实现人人享有心理健康护理,我们必须了解人们面临的问题,并从以下三个方面采取预防手段。

早期预防:解决根本问题

新冠疫情为看待心理健康带来了新的视角,因为人们面临着越来越多的孤独、日常干扰和焦虑。事实上,根据安泰和晨间咨询公司(Morning Consult)的数据,在18-34岁的美国人中,自新冠疫情爆发以来,担心自己或家庭成员、家人或朋友心理健康的人达到惊人的65%。然而该研究还发现,近四分之一的受访者对寻求帮助解决问题没有信心。

一个行之有效的方法就是在产生抑郁和焦虑情绪前解决孤独问题。我们应该把有相同经历的人群组织在一起,让面临困境的人们不再感到孤独。就像安泰近期为女性、非裔美国女性、母亲以及有特殊需求儿童的母亲主办了Here4U高峰论坛,参会者称与他人联系感提升了31%,这表明该活动对参会者的心理健康产生了积极影响。

员工援助计划(EAPs)也是一种预防心理健康问题升级的有效方式,该模式可以针对一系列广泛问题,向员工提供全天候生活援助,从而降低员工无助、焦虑或抑郁的风险。事实上,一项研究发现,在开展员工援助计划的公司里,员工的生活满意度提高了24%,工作压力降低了10%。但是我们要说的是,员工援助计划可不仅仅是效率提升工具。安泰的员工援助计划服务叫“生活资源”,就是为面临压力和焦虑、家庭冲突、法律和财务问题、悲伤和损失甚至孤独的医疗保险会员提供支持的例证。

二级预防:早期症状和治疗选择

八分之一的急诊科就诊病例与心理健康或药物滥用有关,说明错过了识别早期症状避免发展为急症病例的机会。个人日常生活中和与医疗保健系统互动时,积极主动提供心理健康资源,我们就能有效地发现心理健康需求的早期迹象,引导人们过上幸福生活。

对于医疗保健行业来说,分析患者数据是识别早期心理健康需求最有效的方法之一。在“次优行动”(Next Best Actions)中,我们的数据科学家基于消费者过去行为和偏好数据,指导安泰会员选择可能实现最佳整体福利的决策或服务。例如,在患有慢性病的安泰会员中,我们使用医疗索赔数据识别心理健康风险更高的成员,并主动提供援助支持。

医疗服务提供者在早期发现需求方面也发挥着关键作用,尤其是76%的医疗服务提供者表示患者里有中高比例面临心理健康问题。我们可以向医疗服务提供者提供指南、工具和资源,识别面临心理健康挑战的人,并引导他们获得适当的护理,正如安泰与精神健康中心的合作,在预防心理健康问题进一步发展方面具有重要的意义。

为了支持在其他医疗保健环境中发现心理健康需求,CVS Health在“一分钟诊所”预约期间提供心理健康筛查,并在选定的心理健康中心授权临床社会工作者提供虚拟或现场心理健康评估和治疗规划。有效的早期识别方法必然结合积极主动接触消费者、医疗服务提供者培训以及在当地社区和其他护理环境中嵌入资源等能改善心理健康的措施。

三级预防:治疗干预

干预更侧重于临床问题出现时采取行动,也是防止心理健康问题恶化的重要方面。我们一直在不断改进心理健康干预模式,现在获得治疗比以往更容易,可以亲自看心理医生,也可以视频会话或发送信息。

2020年,60%的安泰商业保险会员利用远程医疗服务完成心理健康就诊,而2019年这一比例仅为1%。今年仍将继续保持较高比例,进展相当积极!有证据显示远程医疗对心理健康保健有效很好,对于担心面对面接受治疗的人来说,这可能是很好的选择,因为利用远程方式与医疗服务提供者联系更便捷。研究还表明,将远程医疗健康纳入早期护理并增加远程心理治疗机会,可以改善患者的心理健康状态。

我们还了解到,人们越来越希望在社区中更方便地获得医疗服务,而且还要与整体医保计划和生活方式挂钩,将身心健康治疗与购买其他健康产品和处方药关联起来。有关该问题的积极探索包括:扩大向家庭派送心理健康药物的范围,确保人们遵从用药指导,尽快恢复健康并预防未来的风险。

预防性护理是非常有效的方式,绝不能忽视其在各类健康问题里发挥的作用,包括对心理健康的影响。随着人们对自身、关心的人和社区的心理健康问题关注持续上升,安泰和CVS Health将持续努力避免人们感到孤独,同时也支持全国各地的医疗服务提供者和公司合作伙伴采取同样措施。通过这项工作,我们可以推动社区、工作场所和家庭在心理健康方面取得进展。(财富中文网)

医学博士李奎是CVS Health的高级副总裁兼安泰首席医疗官。卡拉·克纳尔蒂是安泰行为健康总裁。刑恩博士是安泰首席精神卫生官。

译者:冯丰

审校:夏林

众所周知,关于心理健康的讨论正在增加。虽然想得出结论还需要一些时间和努力,但值得欣慰是,关于长期以来被严重污名化的话题的讨论更多了。

类似世界精神卫生日(World Mental Health Day)的纪念活动有助于推动亟需的对话。然而,纪念日除了本身很重要,也在提醒人们每一天都要当成精神健康日。人们生活中总会遇到影响幸福感的压力、事件和诊疗,新冠疫情进一步凸显了该现实,所以掌握预防和护理方法以满足心理健康需求变得至关重要。

在CVS Health旗下保险公司安泰(Aetna),我们深知轻则承受焦虑或压力,重则长期接受临床诊疗,如果有人面临类似问题,都会存在心理和情绪健康需求。为了真正实现人人享有心理健康护理,我们必须了解人们面临的问题,并从以下三个方面采取预防手段。

早期预防:解决根本问题

新冠疫情为看待心理健康带来了新的视角,因为人们面临着越来越多的孤独、日常干扰和焦虑。事实上,根据安泰和晨间咨询公司(Morning Consult)的数据,在18-34岁的美国人中,自新冠疫情爆发以来,担心自己或家庭成员、家人或朋友心理健康的人达到惊人的65%。然而该研究还发现,近四分之一的受访者对寻求帮助解决问题没有信心。

一个行之有效的方法就是在产生抑郁和焦虑情绪前解决孤独问题。我们应该把有相同经历的人群组织在一起,让面临困境的人们不再感到孤独。就像安泰近期为女性、非裔美国女性、母亲以及有特殊需求儿童的母亲主办了Here4U高峰论坛,参会者称与他人联系感提升了31%,这表明该活动对参会者的心理健康产生了积极影响。

员工援助计划(EAPs)也是一种预防心理健康问题升级的有效方式,该模式可以针对一系列广泛问题,向员工提供全天候生活援助,从而降低员工无助、焦虑或抑郁的风险。事实上,一项研究发现,在开展员工援助计划的公司里,员工的生活满意度提高了24%,工作压力降低了10%。但是我们要说的是,员工援助计划可不仅仅是效率提升工具。安泰的员工援助计划服务叫“生活资源”,就是为面临压力和焦虑、家庭冲突、法律和财务问题、悲伤和损失甚至孤独的医疗保险会员提供支持的例证。

二级预防:早期症状和治疗选择

八分之一的急诊科就诊病例与心理健康或药物滥用有关,说明错过了识别早期症状避免发展为急症病例的机会。个人日常生活中和与医疗保健系统互动时,积极主动提供心理健康资源,我们就能有效地发现心理健康需求的早期迹象,引导人们过上幸福生活。

对于医疗保健行业来说,分析患者数据是识别早期心理健康需求最有效的方法之一。在“次优行动”(Next Best Actions)中,我们的数据科学家基于消费者过去行为和偏好数据,指导安泰会员选择可能实现最佳整体福利的决策或服务。例如,在患有慢性病的安泰会员中,我们使用医疗索赔数据识别心理健康风险更高的成员,并主动提供援助支持。

医疗服务提供者在早期发现需求方面也发挥着关键作用,尤其是76%的医疗服务提供者表示患者里有中高比例面临心理健康问题。我们可以向医疗服务提供者提供指南、工具和资源,识别面临心理健康挑战的人,并引导他们获得适当的护理,正如安泰与精神健康中心的合作,在预防心理健康问题进一步发展方面具有重要的意义。

为了支持在其他医疗保健环境中发现心理健康需求,CVS Health在“一分钟诊所”预约期间提供心理健康筛查,并在选定的心理健康中心授权临床社会工作者提供虚拟或现场心理健康评估和治疗规划。有效的早期识别方法必然结合积极主动接触消费者、医疗服务提供者培训以及在当地社区和其他护理环境中嵌入资源等能改善心理健康的措施。

三级预防:治疗干预

干预更侧重于临床问题出现时采取行动,也是防止心理健康问题恶化的重要方面。我们一直在不断改进心理健康干预模式,现在获得治疗比以往更容易,可以亲自看心理医生,也可以视频会话或发送信息。

2020年,60%的安泰商业保险会员利用远程医疗服务完成心理健康就诊,而2019年这一比例仅为1%。今年仍将继续保持较高比例,进展相当积极!有证据显示远程医疗对心理健康保健有效很好,对于担心面对面接受治疗的人来说,这可能是很好的选择,因为利用远程方式与医疗服务提供者联系更便捷。研究还表明,将远程医疗健康纳入早期护理并增加远程心理治疗机会,可以改善患者的心理健康状态。

我们还了解到,人们越来越希望在社区中更方便地获得医疗服务,而且还要与整体医保计划和生活方式挂钩,将身心健康治疗与购买其他健康产品和处方药关联起来。有关该问题的积极探索包括:扩大向家庭派送心理健康药物的范围,确保人们遵从用药指导,尽快恢复健康并预防未来的风险。

预防性护理是非常有效的方式,绝不能忽视其在各类健康问题里发挥的作用,包括对心理健康的影响。随着人们对自身、关心的人和社区的心理健康问题关注持续上升,安泰和CVS Health将持续努力避免人们感到孤独,同时也支持全国各地的医疗服务提供者和公司合作伙伴采取同样措施。通过这项工作,我们可以推动社区、工作场所和家庭在心理健康方面取得进展。(财富中文网)

医学博士李奎是CVS Health的高级副总裁兼安泰首席医疗官。卡拉·克纳尔蒂是安泰行为健康总裁。刑恩博士是安泰首席精神卫生官。

译者:冯丰

审校:夏林

It’s no secret that conversations around mental health are on the rise. Though it took a while to get here, we are proud to see more discussions take place on a topic that, for too long, has been highly stigmatized.

Observances such as the World Health Organization’s World Mental Health Day today help elevate this much needed dialogue. However, while these days are important, they also remind us to treat every day as a mental health day. People constantly face stressors, events and diagnoses that impact our overall well-being, a reality that the COVID-19 pandemic has further revealed, making it critical that our approach to preventing and caring for these mental health issues meets these needs.

At Aetna, a CVS Health company, we understand that every individual sits along a continuum of mental and emotional health needs—from facing moments of anxiety or stress to longer-term clinical diagnoses, and everything in between. To truly make mental health care a reality for all, we must meet people where they are along this continuum through a three-pronged approach to prevention.

Primary prevention: Addressing root causes

The COVID-19 pandemic has put a new lens on how we think about mental well-being, as people have faced increased levels of loneliness, routine disruption and anxiety. In fact, Aetna and Morning Consult data found that a staggering 65% of Americans ages 18-34 have had concerns about their own mental health or that of household members, family or friends since the pandemic outbreak began. Yet, the study also found that nearly one in four of the same respondents are not confident in finding help to address these concerns.

Addressing loneliness is one way we can lower feelings of depression and anxiety before they even start. Bringing together communities that have faced similar experiences, such as through forums like Aetna-hosted Here4U sessions, allows people to feel that they are not alone in the struggles they face. The Here4U sessions held recently for women, African American women, moms, and moms of children with special needs have demonstrated a positive impact on attendees’ mental health, with participants reporting a 31% improvement in feeling connected to their peers.

Employee Assistance Programs (EAPs) are also valuable modes of preventing escalated mental health concerns, as they provide 24/7 life assistance across a wide range of issues that can lower risks of feeling overwhelmed, anxious or depressed. In fact, one study found that companies with EAPs see a 24% improvement in life satisfaction and a 10% reduction in workplace distress among their workers. But we need to better inform people that EAPs are more than a workplace productivity tool. Aetna’s Resources for Living, which provides EAP services,is one example of a resource that supports those facing stress and anxiety, family conflict, legal and financial issues, grief and loss and even loneliness among our Medicare members.

Secondary prevention: Early signs and treatment options

One in eight emergency department visits are related to mental health or substance abuse, demonstrating missed opportunities to identify early signs of mental health concerns before they rise to an emergency. By proactively surrounding individuals with mental health resources, in their everyday lives and when interacting with the health care system, we can effectively spot early signs of mental health needs and direct people on the right path to well-being.

For the health care industry, one of the most effective ways we can identify mental health needs early is through patient data analysis. As part of Next Best Actions, our data scientists use consumer data on past behaviors and preferences to guide Aetna members toward decisions or services that will achieve their best total well-being. For example, we use data from medical claims to identify members with chronic conditions who are likely at higher risk for having a mental health issue and proactively reach out to them with resources for support.

Providers also play a critical role in early detection of these needs, especially with 76% reporting a high or moderate proportion of their patients face mental health issues. Arming providers with instructions, tools and resources to identify and direct those facing mental health challenges to the right care, such as through Aetna's work with PsychHub, can lead to meaningful change toward preventing further mental health concerns.

To support spotting mental health needs in other health care settings, CVS Health provides mental health screenings during MinuteClinic appointments, and licensed clinical social workers in select HealthHUB locationsprovide virtual or in-person mental health assessments and treatment planning. An effective approach to early detection combines all of these measures—proactive consumer outreach, provider training and embedding resources in local communities and other care settings—to improve mental health.

Tertiary prevention: Intervening with treatment

While intervention is more focused on the action taken when a clinical issue has already presented itself, it is an equally important aspect of preventing mental health needs from worsening. Mental health care is accessible in more ways than we’ve ever seen before—from seeing a therapist in person, to connecting virtually or over the phone to text, we are continuously evolving modes of mental health intervention.

Among Aetna’s Commercial members, 60% of outpatient mental health visits were done via telemedicine in 2020, up from just one percent in 2019. That higher figure is holding steady through this year, which is a positive development! Telemedicine has proven to be particularly effective for mental health care as it allows for greater convenience in connecting with a provider, and it can be a good option for those who are apprehensive about receiving this kind of care in person. Studies have also shown that integrating telebehavioral health into primary care and increasing access to telepsychiatry has led to improvements in patients’ mental health.

We also know that individuals increasingly want to receive care conveniently in their communities, and in a way that is connected to their overall health care plan and lifestyle—connecting their physical and mental health care to where they are shopping for other well-being products and picking up their prescriptions. The expansion of home delivery of mental health medications to ensure people adhere to medication guidance to recover and prevent future risks is another positive step in this regard.

Preventive care is powerful, and we must not forget the influence it has on all aspects of our health, including our mental well-being. As the focus on the mental health of ourselves, loved ones and communities continues to rise, Aetna and CVS Health remain committed to ensuring that no one is alone on this journey and supporting our partner providers and companies across the country to do the same. Through this work, we can make progress toward improving mental health for our communities, workplaces and families.

Kyu Rhee, M.D. is senior vice president and Aetna chief medical officer at CVS Health. Cara McNulty is the president of Aetna Behavioral Health. Hyong Un, M.D. is chief psychiatric officer at Aetna.

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